A former Van Nuys physician, medical government and the clinic and laboratory the place they labored pays $15 million to settle allegations that they submitted false Medicare and Medi-Cal claims, paid unlawful kickbacks and self-referred sufferers, in accordance with the Division of Justice.
The DOJ introduced on Thursday, Dec. 26 that the previous physician, Mohammad Rasekhi of Van Nuys, and an government that labored for the lab and clinics, Sheila Busheri, and the lab and clinics agreed to pay to settle the claims.
“There is an expectation that providers who receive Medicare and Medicaid program funds obey the law and operate with integrity,” stated Performing Particular Agent in Cost Eric Larson of the U.S. Division of Well being & Human Providers Workplace of the Inspector Basic.
The allegations state that the defendants “knowingly submitted or caused the submission of false claims to Medicare and Medi-Cal.”
They allegedly did this by paying kickbacks to entrepreneurs to refer sufferers to their clinics, paying kickbacks to third-party clinics to refer Medicare and Medi-Cal sufferers to their laboratories and referring sufferers from their clinics to their laboratory when self-referral, or referral to an entity {that a} doctor or their member of the family has a monetary relationship with, just isn’t allowed.
The kickbacks to third-party clinics for referring sufferers to their labs had been allegedly “above-market rent payments, complimentary and discounted services to clinic staff, and write-offs of balances owed by patients and clinic staff.”
Rasekhi based Southern California Medical Heart (SCMC) and served as its chief medical officer and co-owns Common Diagnostic Laboratories. Busheri is the chief government officer of SCMC and co-owns and is the chief government officer of Common Diagnostic Laboratories (UDL). SCMC has six clinics all through Southern California.
Rasekhi, Busheri, UDL and SCMC are accused of violating the Anti-Kickback Statue and the Doctor Self-Referral Regulation. Rasekhi surrendered his medical license in Dec. 2024.
Former staff and managers of the labs and clinics filed a declare underneath the False Claims Act, underneath the whistleblower provisions. They filed on behalf of america and can obtain $5 million within the settlement. The DOJ calls the False Claims Act “one of the most powerful tools” within the battle towards healthcare fraud.
The state of California, which paid a number of the claims concerned, will obtain $7 million.
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